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Preventive Care Guidelines

Preventive Care For Women 65+

Below is a preventive care plan for women ages 65 and over. You and your health care provider may decide that a different schedule is best for you, this plan can guide your discussion.

Screening

Who needs it

How often

Alcohol misuse All adults At routine exams
Blood pressure All adults Every 2 years if your blood pressure reading is less than 120/80 mm Hg*

Yearly if your systolic blood pressure reading is 120 to 139 mm Hg or your diastolic blood pressure reading is 80 to 89 mm Hg*

Colorectal cancer All adults ages 50 and older According to the American Cancer Society:
For tests that find polyps and cancer:

  • Flexible sigmoidoscopy every 5 years1, or
  • Colonoscopy every 10 years, or
  • Double-contrast barium enema every 5 years1

For tests that primarily find cancer:

  • Yearly fecal occult blood test2, or
  • Yearly fecal immunochemical test every year2, or
  • Stool DNA test, interval uncertain2

The tests that are designed to find both early cancer and polyps are preferred if these tests are available to you and you are willing to have one of these more invasive tests; talk with your doctor about which test is best for you

Dental Exam All adults Annually
Depression All adults with access to a clinical practice that has staff and systems in place to assure accurate diagnosis, effective treatment, and follow-up At routine exams
Diabetes mellitus, type 2 Adults who have no symptoms and have sustained blood pressure (treated or untreated) greater than 135/80 mm Hg At least every 3 years
Hearing Test All adults ages 65+ Every 1-2 years
HIV Anyone at increased risk for infection At routine exams
Lung Cancer Screening Smokers/those who smoked Check with your provider
Lipid disorders All adults At least every 5 years
Mammogram Women up to age 75 Every 1-2 years, check with your provider
Obesity All adults At routine exams
Osteoporosis Screening All women over age 64 should have a bone density test (DEXA Scan) Annually
Pelvic Exam & Pap Smear After age 65, most women who have not been diagnosed with cervical cancer or pre cancer can stop having pap smears as long as they have had 3 negative tests within the past 10 years Check with your provider
Syphilis Anyone at increased risk for infection At routine exams
Tuberculosis Anyone at increased risk for infection Check with your health care provider
Vision All adults3 Every 1 to 2 years; if you have a chronic disease, check with your health care provider for exam frequency

 

Counseling

Who needs it

How often

Aspirin for primary prevention of cardiovascular events Women ages 45 to 79 when potential benefits from a decrease in heart attacks outweigh the harm or risks from an increase in gastrointestinal hemorrhage When diagnosed with risk for cardiovascular/heart disease; check with your health care provider before starting
Diet, behavioral counseling Adults with hyperlipidemia and other known risk factors for cardiovascular and diet-related chronic disease When diagnosed
Tobacco use and tobacco-related disease All adults Every visit

 

Immunization

Who needs it

How often

Tetanus/diphtheria/pertussis (Td/Tdap) booster All adults Every 10 years. Tdap is recommended if you have contact with a child younger than 12 months. Either Td or Tdap can be used if you have no contact with infants.
Measles, mumps, rubella (MMR) All adults ages 65 and older who have no previous infection or documented vaccinations** One dose
Chickenpox (varicella) All adults ages 65 and older who have no previous infection or documented vaccinations** Two doses; second dose should be given at least 4 weeks after the first dose
Flu vaccine (seasonal) All adults Yearly, when the vaccine becomes available in the community
Hepatitis A vaccine People at risk4 Two doses given at least 6 months apart
Hepatitis B vaccine People at risk5 Three doses; the second dose should be given 1 month after the first dose, and the third dose given at least 2 months after the second dose (or at least 4 months after the first dose)
Pneumococcal (polysaccharide) All adults One dose
Zoster All adults One dose

 

*Recommendation from the ACS. Currently, the U.S. Preventive Services Task Force (USPSTF) recommends screening every 2 years for women ages 50 to 74. The ACS recommends yearly screening for all women ages 40 and older. Women should talk with their doctors about their personal risk factors before making a decision about when to start getting mammograms or how often they should get them. The ACS also recommends annual clinical breast exams (CBEs) for women ages 40 and older. The USPSTF, however, believes there is not enough evidence to assess the value of CBEs for women ages 40 and older. Women should talk with their doctors about their personal risk factors and make a decision about whether they should have a CBE.

**Exceptions may exist, please check with your health care provider

1If the test is positive, a colonoscopy should be done

2The multiple stool take-home test should be used. One test done by the doctor in the office is not adequate for testing. A colonoscopy should be done if the test is positive.

3Recommendation from the American Academy of Ophthalmology

4For complete list, see the CDC website

5For complete list, see the CDC website

6For complete list, see the CDC website

Other guidelines are from the USPSTF

Immunization schedule from the CDC